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As we get older certain changes make us appear aged. Previously the belief among the plastic surgeons was that by cutting off the excess skin of the face and pulling the remaining skin we can make the patient appear younger. Now we believe that the main problem with ageing is loss of volume of the face. Most of the loss occurs in the fat layer of the face. In addition to that some volume is lost in the muscle, bone and other connective tissues of the face. Human fat is the best substance which can be used to fill in that lost volume. The other of other fillers (collagen, restylane, juvederm radiasse etc)  has met with difficulties, including impermanence, foreign body reaction, unnatural texture, and possible disease transmission. In addition, most of the products currently available remain relatively expensive. Some materials, such as silicone, have resulted in spectacular failures. Small volumes of liquid silicone formerly were used as free injections. Defects intentionally were under corrected, since the ongoing soft tissue reaction created additional volume. However, the reaction of the host tissue led to late complications including chronic edema, lymphadenopathy, scarring, skin ulceration, skin thinning and discoloration, and siliconomas.

Human fat contains adult stem cells. As we lose fat we lose some of these stem cells. These stem cells has the ability to repair damaged tissue. By replacing the lost fat with fat from another part of the body we can rejuvenate the face as well as replace the lost stem cells. The fat is obtained with liposuction using the tumescent technique.  The removed fat is centrifuged and only the clean fat is used for injections to rejuvenate the face.  Commonly all the troublesome lines of the face are corrected with injections. These include frown lines, Crows feet lines, nasolabial folds, the eye bags, marionette lines.  As people age lips get thinner and start to down-slope at the corners. As the lips loose volume vertical lines appear around the lips call rytids. There are various injectable fillers which have many side effects. The main side effect which made me abandon use of any of these is that these fillers decrease the normal blood supply to the face and thereby increase the Ageing process. To learn more about fillers and their side effects read here.  What happens if you get too much fat grafted.  In that case the fat can be removed with a tiny fiberoptic laser which can go under the skin through a needle hole. The fat removal will actually cause your skin to tighten even further due to the subdermal heat of the process. Some areas of the face can be tightened with this Sub Dermal Laser Tightening.

What about wrinkles of the face?

As you age wrinkles settle on your skin. Women worry about this to a greater extent than men. The wrinkles tend to make people look older with age. A bride waiting to capture her best look on her wedding photos does not want those wrinkles on the face.

Some times wrinkles appear and get deeper even before you have aged. The main reasons are quick weight loss, sun damage, acne damage and genetic tendencies.

For a bride who wants to soften her skin wrinkles the treatment of choice would be skin fillers. There are many artificial skin fillers such as collagen, restylane, juvederm etc. These provide only a temporary relief. They displace your normal circulation therefore in the long term does not help the ageing and may in fact aggravate it. The best filler in the world to treat skin wrinkles is your own fat.

Reasons why the fat is the best filler in the world for you are these. 1. fat is the cheapest filler  2. It can last as long as you live  3. stem cells in the fat can rejuvenate and repair your aged face  4. Excess fat can be removed with new laser techniques (fiberoptic Nd-Yag Laser) while fillers cannot be removed safely like that. 5. Fat filling gives you younger face and the most natural look since losing fat was the reason why you actually got wrinkles in the first place. 6. Fat will bring more circulation as new capillaries grow into the new fat tissues thereby slowing down your ageing process.

One of the piorneers of fat grafting Dr Sydney Coleman who is one of my teachers has said this recently. " "When I began transplanting fat twenty-four years ago, I noticed an interesting development. The quality of my patients' skin overlying the areas I had grafted improved dramatically over time. I observed decreased wrinkling, smaller pores and improved color and tone. We now know that there is a high concentration of stem cells in fat. So, with each fat transfer, stem cells that can potentially repair aging and sun damaged skin are transplanted as well. We are now looking into how to maximize that extraordinary effect."

 

   These are frown lines

   These are crows feet lines

Naso-labial folds

  Marionette lines

Above photographs were taken of the same person twenty years apart. It shows the changes occurring in the facial skin as well as of the facial volume. Correction of the changes which occurred with ageing require skin laser treatments as well as replacement of the volume with patients own fat.

Above picture shows rejuvenation obtained with fat grafting to the face. Marionette lines have virtually disappeared in this patient. The entire face was lifted and the patient told us that she looked 20 years younger. She achieved the desired results with one operation. In certain patients with either deep wrinkles or poor circulation the fat grafting can be repeated safely after about three months to six months.

This is the results following one fat graft and one liposuction of chin and jowls.  Patient wants further rejuvenation and is undergoing a second fat graft. The pictures are to follow.

 

In this patient fat is injected to improve the nasolabial folds.

 

In this patient the vertical lines around the lips occurred with ageing.  These are called rhytides. She looks younger following augmentation of her lips with the fat grafting. Although the lips can be augmented with fillers such as collagen and restylane the results obtained with fat grafting is far superior.  The artificial fillers are short lasting and can displace the natural circulation and thereby increase the ageing process. The fat grafts encourage more blood vessel formation and increases the blood supply to the face. Therefore fat grafting can slow down a persons ageing process.

This patient had fat grafting of her face for rejuvenation. She had improvement of the downsloping of corners of her mouth, fullness of her lips and fullness of her cheeks restored as shown in the after picture.

In this patient improvement of the eyebags as well as marionette lines can be seen in the after picture. The patient was 68 years at the time of surgery and was very happy with the results.

In this patient multiple fine wrinckles were treated with fat grafting with satisfactoy results as seen on the above picture.

In this patient  fat grafting was performed only in the upper face to remove the deep frown line as well as eye bag lines. Satisfactory improvement of these lines is seen in the after pictures.

This patient had her cheeks and lips improved with fat grafting.

Is this technique suitable for Sri Lankans?  Absolutely. It works for any race and color. Can you make somebody more beutiful and younger at the same time? Absolutely.

Another Sri Lankan patient who was depressed about the sad and tired look she got with aging. Picture in the right was obtained after one fat grafting to the face with three treatments of IPL RF and CO2 laser resurfacing and three months of day cream and night cream use.

What are the options for a patient with excessive premature ageing. This patient had excessive fat loss from cheeks and around the mouth. With one stage of fat grafting we obtained a significan correction of her ageing as well as a brow lift. She is recommended to do a second stage in about three months after the first stage to rejuvenate her face further.  This is a good example of thinning of the face resulting from fat grafting which create a lift of the whole face. Most patient get a fatter face because of the dropping of the skin associated with ageing. With fat grafting we can obtain a significant lift of the entire face even the forehead and get the exact face you had 20 years ago. With the new tissues in the face and new and improved circulation further aging is minimized for decades.

Following the fat grafting patients are given a cold laser treatment to activate the stem cells grafted into the area. This treatment is repeated three times weekly to obtain the best rejuvenating result.

In this case a small and unsightly upper lip following a cleft lip surgery had been made attractive with a fat graft.

Fat transfer to the hand

A wrinkled, bony hand with large veins, sun spots and deep grooves can reveal an advanced age even though the patientís face, breasts or body have been surgically rejuvenated. Consequently, plastic, dermatological and cosmetic surgeons have developed techniques to make hands also look younger. A few practitioners use dermal fillers like Restylane and Juvederm but the longer lasting method seems to be fat transfer via injection which is reported to last for years.

These are hands of  a 34 year old Sri Lanka Female. She did not want the aged look of her hands and requested fat grafting to be done to rejuvenate her hands. Picture on the right shows the results one month following the fat grafting. As patient get older they may need more than one session of fat grafting to obtain a very good result. Younger patients do better with fat grafting.

SDLT (subdermal laser tightening)

After rejuvenating the face with the fat grafting we address the areas of forehead and neck with Subdermal Laser Tightening. SDLT therapy for short. 

I use laserlite with a 1mm fiberoptic under the skin to tighten these important areas which can be tightened with safety.

The procedure takes only about four hours and the results can be quite stunning. I have performed over 100 of these procedures in USA with great results. The pictures shown below show the results achieved in three months.


       Before                                    After


     Before                                    After


  Before                                  After

We are offerring the above procedure at a greatly discounted price of 70000 Rupees.

After performing the above two procedures you can maintain the best results using photofacial treatments using the latest techniques.

The complete skin program for immediate, visible and long lasting results, photofacial using the visibile light combined with radiofeqeuncy provides you with the best option.

You can think of it as a combination of light and magnetic waves. These treatment will make you skin young again with best skin color and tone. It removes the ugly brown and red areas caused by too much circulation as well as pigmentation is the skin.

for somebody who has never used these treatments we recommend doing three treatments once a month. It can be done in about fifteen minutes. It can be combined with fraxel resurfacing to remove ugly scars such as caused by Acne, Chickenpox or lines around the eyes, forehead as well as mouth.

The light waves comes with different wave lengths which can be used to remove unwanted hair, veins, acne as well. Please ask us if you have these specific needs.

Antiageing laser is ideal to obtain a younger look.  It is recommended to be performed monthly for three treatments and then once in six months for the maintenance.

Above treatment shows improvement of the skin color tone and fine wrinkles.

Above picture shows improvement of the skin following five  treatments.


      Before                                                                  After